Organization Active NPI

Mount Laurel Physical Therapy

  • Physical Therapy Clinic/Center
  • Mount Laurel, NJ
National Provider Identifier
1386505378
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MOUNT LAUREL PHYSICAL THERAPY
Practice address
55 Bolz CT
Mount Laurel, NJ 08054-3377
Phone
(607) 342-1294
NPI assigned
Nov 19, 2025
Last updated
Nov 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenan Nuhodzic, PT, DPTNPI 1598287336
Title
Ower
Phone
(607) 342-1294

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

55 Bolz CT
Mount Laurel, NJ 08054-3377

Mailing address

55 Bolz CT
Mount Laurel, NJ 08054-3377
Phone (607) 342-1294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260327003644 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0446735401 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Laurel, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1386505378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BOLZ CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543377",
            "telephone_number": "607-342-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BOLZ CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543377",
            "telephone_number": "607-342-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT LAUREL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "NUHODZIC",
        "authorized_official_first_name": "KENAN",
        "authorized_official_title_or_position": "OWER",
        "authorized_official_telephone_number": "607-342-1294",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.